Saturday Quack – What Doesn’t Help When Quitting Smoking
Sat, August 23, 2008 at 02:00AM It’s extremely difficult to quit smoking, as those who’ve tried can tell you. A new report in the journal Bandolier has looked at all the ways people use to help them quit, and the findings are rather disappointing. There’s only a single intervention that works in more than 1 in 10 people trying to quit: varenicline medication. See how the other methods fared, below.
Bandolier is a monthly UK journal that publishes reviews of evidence-based medicine. In its attempt to put the results of clinical studies into perspective, it likes to use the measurement “Numbers Needed to Treat” (NNT) wherever possible. Clinical studies concentrate on whether a treatment works, or not. But more important is the question, how well does the treatment work? The NNT is a useful way of looking at results of studies because it expresses the therapeutic effort that is needed to get a therapeutic result – i.e. how many people need to be treated to get the desired result.
Here are the various methods derived from 12 reviews of clinical studies in smoking cessation, covering over 127,000 subjects studied in appropriately-controlled trials, along with their NNTs. A ‘positive’ result means not smoking at 6 months after starting the intervention.
Nicotine replacement 16
Buproprion 11
Varenecline 7
Nortriptyline 9
Clonidine 9
Physician intervention 30
Self help 65
Counseling 26
Group therapy 22
Exercise 24
I hate to tell you, but this shows that prescription medications are the only effective aids to quitting smoking. Varenecline, with a NNT of 7, nortryptiline (9), clonidine (also 9), and bupropion (11) are clearly more effective than the non-medicinal interventions. Trying to go it alone (self help) is only effective in 1 in 65 people.
Note that the above NNT quoted include the comparison with the placebo used, which may explain why acupuncture and hypnosis don’t feature on the list. Placebo responses with both these treatments can be considerable.
Reader Comments (1)
Just wanted to say hello all. This is my first post.
I expect to learn a lot here.